Long-term follow-up of patients undergoing allogeneic bone marrow transplantation for acute myeloid leukemia in first complete remission after cyclophosphamide-total body irradiation and cyclosporine

J. Mehta*, R. Powles, J. Treleaven, C. Horton, D. Tait, S. Meller, C. R. Pinkerton, G. Middleton, T. Eisen, S. Singhal

*Corresponding author for this work

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Eighty-five patients (median age 28 years) with acute myeloid leukemia (AML) in first remission underwent allogeneic bone marrow transplantation (BMT) from HLA-identical siblings between 1978 and 1987 after cyclophosphamide and single-fraction total body irradiation with cyclosporine for graft-versus-host disease (GVHD) prophylaxis. The actuarial probabilities of development of acute and chronic GVHD were 57% and 47%, respectively. Twenty-six patients died of transplant-related complications at a median of 3.5 months, and two of unrelated causes. Seventeen patients relapsed at a median of 6.5 months. Forty patients were alive and well at 74-197 months (median 157) after BMT; seven (18%) with limited chronic GVHD requiring therapy. The actuarial 10-year probabilities of transplant-related death, relapse, and disease-free survival were 33%, 25% and 48% respectively. In multivariate analysis, infusion of a lower cell dose, development of GVHD, and age > 35 years were associated with increased transplant-related mortality, donor-recipient ABO incompatibility with a lower relapse rate, and age > 35 years and a lower cell dose with poorer disease-free survival. We conclude that with long-term follow-up, allografting in AML after cyclophosphamide-TBI and cyclosporine has resulted in disease-free survival that is comparable to most currently reported series. Patients who are alive and well 3-4 years after BMT have excellent prospects of long-term survival.

Original languageEnglish (US)
Pages (from-to)741-746
Number of pages6
JournalBone Marrow Transplantation
Volume18
Issue number4
StatePublished - Oct 1996

Keywords

  • Acute myeloid leukemia
  • Cyclophosphamide
  • Cyclosporine
  • Graft-versus-host disease
  • Total body irradiation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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